Aneurysms of the vein of Galen in infants aged 2 to 15 months. Diagnosis and natural evolution

Abstract

This is a report of seven cases of aneurysm of the vein of Galen (AVG) with a review of the clinical and radiological aspects of 48 cases in the literature. The natural evolution and pathophysiology of this vascular malformation are discussed. The clinical signs of this condition are often misleading. The appearance of AVG on CT is pathognomic. Surveillance of the vascular malformation and associated cerebral lesions can be maintained with subsequent CT. Spontaneous thrombosis of the aneurysm was observed in three cases. The diagnosis of thrombosis of the AVG was always made at operation or by histological examination. The radiological appearance of a thrombosed aneurysm is typical.

Nonmicrocephalic Infants with Congenital Zika Syndrome Suspected Only after Neuroimaging Evaluation Compared with Those with Microcephaly at Birth and Postnatally: How Large Is the Zika Virus “Iceberg”?

“…This could explain the cortico-subcortical calcifications, the development of hydrocephalus in some of the infants, 24 and changes in brain lesions, 23,25 similarly to what happens in cerebral venous hypertension of the physiopathology of vein of Galen aneurysmal malformations. 26 The confirmation of this vascular hypothesis could lead to research for identifying treatment options during pregnancy and after birth, improving the prognosis of the infants and the evolution of the disease. The identification of changes in parechyma thickness, ventricle size and calcifications 23,25 indicates that these infants should be followed not only clinically, but also by laboratory tests (possibility of persistent viral activity) and by neuroimaging, especially if there are signs of disease progression.…”

Spontaneous Thrombosis of Vein of Galen Aneurysmal Malformation

“…This diagnosis was made histologically after surgery for a presumptive tumor of the pineal region. Our ability to make this diagnosis radiographically has improved markedly since then, and other reports with completely thrombosed AVG have been published [5, 6, 7, 8, 9, 10, 11, 12, 13, 14]. Treatments for these lesions have included partial excision and/or ventriculoperitoneal shunting.…”

“…Group 4 consists of older children with headache as their initial symptom. In earlier series, every case in this group had a calcified rim or ring in the pineal region on plain skull films, and recurring episodes of exercise syncope (suggesting a ‘steal’ phenomenon), subarachnoid hemorrhage [7]or exophthalmos could accompany the clinical picture.…”

Vein of Galen Malformation with Cerebral Calcification: A Reversible Cause of Neurodegenerative Disease

“…1617 White matter calcification has also been demonstrated in a mentally normal 20 month old child with a VGM. 13 Cortical calcification with underlying atrophy has been documented in a 2 year old with a posterior fossa dural arteriovenous malformation l!i but no clini- cal details were given. The two patients described here had extensive cerebral calcification.…”